Derek James Pickett, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

9529 Issued in TN

Practice address

1312 Hanover St
Chattanooga, TN 37405-4353

Phone

(423) 266-1714

NPI assigned

Jul 6, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1114282126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 STERLING AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374054228",
            "telephone_number": "423-240-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 HANOVER ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374054353",
            "telephone_number": "423-266-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "DEREK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "9529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physicians Surgery Center of Chattanooga, LLC
• Tara Marie Pianko, PA-C
• Jimmy Piayas, NP
• Julius A. Piazza III, D.PH.
• Gloria Pickens, LPN
• Michele Albury Pickett, M.D.
• Patricia Ann Pickett, REGISTERED NURSE
• Venkata Pidaparthi
• Carter Alexis Pieper
• Dylan Pieper, DPT

• All providers in Chattanooga, TN
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.